CRU-SAN-93

Code
CRU-SAN-93
Mercy ID
V-03377-01
Encounter Date
07/17/2010
Last
Cruz
First
Sandra
DOB
03/29/1993
County
Dekalb
Street
999 NO LA SABE
City
Atlanta
State
GA
Zip
30345-
Cell
(678) 886-3638
Family Status
Single adult
COB
USA
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Vicente
First
Henrry
DOB
12/12/1982
Address
N/A
Telephone
N/A
COB
Guatemala
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Cristian Cruz 06/25/2008 Grandmother GA/USA -Materna
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana